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Leukeran

Chlorambucil belongs to the group of cancer-fighting medications known as antineoplastics, and specifically to the group of antineoplastics called alkylating agents. It prevents the growth of cancer cells by interfering with the genetic material DNA, which is necessary for reproduction of cells.

Chlorambucil is used to treat cancers of the blood and lymph system, such as certain types of leukemia (e.g., chronic lymphocytic leukemia) and certain types of lymphoma (e.g., non-Hodgkin's lymphomas, Waldenstrom's macroglobulinemia, and Hodgkin's
disease).

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended dose of chlorambucil depends on the condition being treated.

For chronic lymphocytic leukemia, the usual adult starting dose is 0.15 mg per kilogram body weight per day until the total white blood cell count reaches the desired range. 4 weeks after the first course of treatment, the medication may be restarted at a dose of 0.1 mg per kilogram body weight per day.

For Hodgkin's disease, the usual dose is 0.2 mg per kilogram body weight per day for 4 to 8 weeks.

For non-Hodgkin's lymphoma, the usual dose is 0.1 mg to 0.2 mg per kilogram body weight per day for 4 to 8 weeks initially. Maintenance treatment is then started at a reduced daily dose or with intermittent courses of treatment. Chlorambucil may be included as part of a combination treatment with other antineoplastic medications.

As well as interfering with the genetic material DNA of cancer cells, chlorambucil can interfere with some of your normal cells. This can cause a number of side effects. Keep track of any side effects and report them to your doctor as suggested in the section,
"What side effects are possible with this medication?"

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. Do not stop taking this medication without talking with your doctor. If you vomit shortly after taking a dose of the medication, call your doctor for instructions on whether to
skip that dose or to take another dose. If you miss a dose, ask your doctor for instructions. Do not take a double dose to make up for a missed one.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding.

Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people who have contagious infections and tell your doctor if you begin to notice signs of an infection such as fever or chills.

Kidney problems: If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver problems: If you have severe liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Secondary cancer: When used for long periods of time, this medication can increase the risk of developing leukemia. If you are concerned about this, talk to your doctor about the risks and benefits of using this medication.

Seizures: Chlorambucil may increase the risk of seizures in people with a history of seizures, with nephrotic syndrome, or with a head injury. Talk to your doctor about whether any special monitoring is needed.

Surgery: If you need surgery, tell your doctor or anaesthetist that you are taking this medication.

Pregnancy: There is a possibility of birth defects if either the man or woman is taking chlorambucil at the time of conception, or if it is taken during pregnancy. Infertility may occur with the use of chlorambucil. Use effective birth control while
taking this medication. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication may pass into breast milk. Women taking this medication should not breast-feed.

Children: The safety and effectiveness of using this medication have not been established for children.

There may be an interaction between chlorambucil and any of the following:

live vaccines (e.g., mumps, measles, yellow fever)

natalizumab

phenylbutazone

pimecrolimus

roflumilast

tacrolimus (when applied to the skin)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.